Zhou Qing, Soo Ross A, Chang Gee-Chen, Chiu Chao-Hua, Hayashi Hidetoshi, Kim Sang-We, Teraoka Shunsuke, Goto Yasushi, Zhou Jianying, Ho-Fun Lee Victor, Kim Dong-Wan, Han Baohui, Chung Man Ho James, Lin Chia-Chi, Lu Shun, Polli Anna, Calella Anna Maria, Martini Jean-François, Wong Chew Hooi, Mok Tony, Kim Hye Ryun, Wu Yi-Long
Guangdong Lung Cancer Institute, Guangdong Provincial People's Hospital (Guangdong Academy of Medical Sciences), Southern Medical Sciences, Guangzhou, People's Republic of China.
National University Cancer Institute, Singapore.
JTO Clin Res Rep. 2023 Mar 11;4(5):100499. doi: 10.1016/j.jtocrr.2023.100499. eCollection 2023 May.
INTRODUCTION: Lorlatinib is a potent, third-generation inhibitor of ALK. In the planned interim analysis of the ongoing, phase 3, randomized, global CROWN trial (NCT03052608), lorlatinib resulted in significantly longer progression-free survival than crizotinib in patients with previously untreated, advanced, -positive NSCLC. Here, we present a subgroup analysis of Asian patients in the CROWN study. METHODS: Patients received lorlatinib 100 mg once daily or crizotinib 250 mg twice daily. The primary end point was progression-free survival assessed by blinded independent central review. Objective response rate (ORR), intracranial ORR, safety, and select biomarkers were secondary end points. RESULTS: At data cutoff (September 20, 2021), 120 patients were included in the Asian intention-to-treat subgroup (lorlatinib n = 59; crizotinib n = 61). At 36 months, 61% (95% confidence interval [CI]: 47-72) and 25% (95% CI: 12-41) of patients in the lorlatinib and crizotinib groups, respectively, were alive without disease progression (hazard ratio for disease progression by blinded independent central review or death: 0.40; 95% CI: 0.23-0.71). ORR was 78% (95% CI: 65-88) versus 57% (95% CI: 44-70) for patients treated with lorlatinib and crizotinib, respectively. In patients with measurable, nonmeasurable, or both measurable and nonmeasurable brain metastases at baseline, intracranial ORR was 73% (95% CI: 39-94) versus 20% (95% CI: 4-48) for patients treated with lorlatinib and crizotinib, respectively. The definition of nonmeasurable brain metastases is: a brain lesion less than 10 mm in MRI scan is defined as nonmeasurable brain metastasi based on RECIST criteria (Clinical trial evaluation criteria). Hypercholesterolemia, hypertriglyceridemia, and edema were the most frequently reported adverse events with lorlatinib. CONCLUSIONS: Lorlatinib efficacy and safety in the Asian subgroup of CROWN were consistent with those in the overall population.
引言:洛拉替尼是一种强效的第三代ALK抑制剂。在正在进行的3期随机全球CROWN试验(NCT03052608)的计划中期分析中,对于先前未接受过治疗的晚期ALK阳性非小细胞肺癌(NSCLC)患者,洛拉替尼的无进展生存期显著长于克唑替尼。在此,我们展示了CROWN研究中亚洲患者的亚组分析结果。 方法:患者接受每日一次100mg洛拉替尼或每日两次250mg克唑替尼治疗。主要终点是由盲态独立中央审查评估的无进展生存期。客观缓解率(ORR)、颅内ORR、安全性和选定的生物标志物为次要终点。 结果:在数据截止时(2021年9月20日),120例患者被纳入亚洲意向性治疗亚组(洛拉替尼组n = 59;克唑替尼组n = 61)。在36个月时,洛拉替尼组和克唑替尼组分别有61%(95%置信区间[CI]:47 - 72)和25%(95%CI:12 - 41)的患者存活且无疾病进展(根据盲态独立中央审查的疾病进展或死亡风险比:0.40;95%CI:0.23 - 0.71)。接受洛拉替尼和克唑替尼治疗的患者的ORR分别为78%(95%CI:65 - 88)和57%(95%CI:44 - 70)。在基线时存在可测量、不可测量或可测量与不可测量脑转移均有的患者中,接受洛拉替尼和克唑替尼治疗的患者的颅内ORR分别为73%(95%CI:39 - 94)和20%(95%CI:4 - 48)。不可测量脑转移的定义为:根据RECIST标准(临床试验评估标准),MRI扫描中小于10mm的脑病变被定义为不可测量脑转移。高胆固醇血症、高甘油三酯血症和水肿是洛拉替尼最常报告的不良事件。 结论:洛拉替尼在CROWN研究亚洲亚组中的疗效和安全性与总体人群一致。
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